Human Immunodeficiency Viruses

Although the first case of AIDS was described as recently as 1981, the pandemic has escalated at such a rate that by 1993 the World Health Organization (WHO) estimated that over 13 million young adults had been infected with HIV and over 2 million had already developed AIDS, most of whom had died (Fig. 35-3). Approximately 5000 new infections occur every day. By the turn of

Fig. 35-3 Estimated distribution of cumulative HIV infections in adults, by continent or region, as of late 1993. [Based on Weekly Epidemiologual Record, 69, 7 (1994) .]

the century it is projected that 30-40 million will have been infected and that over 1 million will die every year. Moreover, because the principal modes of spread are heterosexual intercourse and perinatal transmission, millions of children will either die from AIDS or be orphaned by the year 2000. In many of the large cities of the United States AIDS is now the commonest cause of death in young adults. However, the situation is even worse in Africa, where 20-30% of the sexually active age group in several cities are already infected, and in Southeast Asia and India, where poverty breeds prostitution and HIV is endemic among this underclass. AIDS threatens the very fabric of society, increasingly targeting the poor and underprivileged. The pandemic is out of control. We have no effective antiviral agent and no immediate prospect of a vaccine. Indeed, if a vaccine with 100% efficacy were discovered tomorrow, millions of currently infected people would still die over the next decade.

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